# RECAREDO T BERBANO PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649491911
- **Authorized official:** RECAREDO TRINIDAD BERBANO JR. MD (MEDICAL DOCTOR OWNER)
- **Authorized official phone:** (570) 718-0520

## Contact information

- **Practice address:** 445 WYOMING AVENUE, KINGSTON, PA 18704
- **Practice address phone:** (570) 718-0520
- **Practice address fax:** (570) 718-0522
- **Mailing address:** 445 WYOMING AVENUE, KINGSTON, PA 18704
- **Mailing address phone:** (570) 718-0520
- **Mailing address fax:** (570) 718-0522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | MD418104 | PA | Yes |

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 06/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001887950 | — | PA |